Ambulance service in Nova Scotia can't keep up with 'unprecedented' call volume

The flu season may be to blame for an "unprecedented" number of calls for ambulances in Nova Scotia during the past six weeks — and the paramedic service can't keep up with demand.

Overall, the volume of calls is only up by one per cent overall in the past six weeks, said the director of provincial operations for Emergency Health Services (EHS), Jeff Fraser.

But a few days have been "exceptionally busy," he said, and that's contributing to a backlog in the system overall.

There have been a handful of days over the past month and a half when more than 700 calls came in over a 24-hour period, Fraser said, compared to the average of 550.

That is "unprecedented," he said. "We have not seen that before."

Fraser speculated the surge in calls might have to do with the flu that's making the rounds.

"When you have a bunch of sick people, the demand can outstrip your resources quickly," he said.

Fraser warned it takes the system "a few days" to recover following a particularly busy day. 

Union tweeting alerts

Spokesperson for the Nova Scotia Paramedics Union, Terry Chapman, said the union has started to send out tweets using the hashtag #codecritical to let Nova Scotians know when there is a shortage of ambulances available.

"This is all that we can think of to do," Chapman said, to "get some assurance that government is listening."

He said this isn't a new problem, and the union has broached the subject with health officials before, but "nothing seems to happen to alleviate it."

The ambulance system is taxed "to the limit," Chapman said, and that means more people are going to start experiencing delays while they wait for paramedics to respond to an emergency call.

Paramedics stuck waiting in hospital

Chad Drover, who has been an advanced care paramedic in Nova Scotia for 17 years, said the problem is compounded by the fact that there often aren't enough beds available in hospital to admit patients who don't need immediate attention.

He said paramedics can spend hours waiting with a patient for a bed to become available.

"I've actually seen crews wait the entire 12 hours with the same patient and not leave" the hospital, Drover said.

Even though the patient has been assessed and is technically in the system, he said, paramedics are not allowed to leave if there is no physician in charge of their care.

"We can't leave the patient," Drover said. "Once they're in our care, we don't abandon them."

Drover said it's an "overall systemic issue" and it's "extremely frustrating" for paramedics who just want to be out in the community doing their jobs. 

You should still call 911

Fraser said he worries that the union's Twitter campaign will send the wrong message.

"We don't want people not to call 911 if they're experiencing an emergency," he said.

He acknowledges that the backlog might mean a longer wait for those who've called for help, but "we do get to everybody" eventually, Fraser said.

In the short term, he said, EHS is shuffling resources in an attempt to cover the gaps in the system. While the service has "added resources" in recent years, Fraser said additional hiring isn't always the best solution.

"Adding another ambulance doesn't necessarily mean better care," he said.

Instead, Fraser said EHS is focusing on programs that keep people out of hospital, by working with palliative care patients and nursing home residents.

'Complex' problem to solve

The senior director of acute medicine for the Nova Scotia Health Authority, Madonna MacDonald, said paramedics end up waiting with patients in emergency rooms because a number of hospitals in the province are "at overcapacity."

The health authority is trying a number of approaches to address the "complex" problem, MacDonald said, including discharging patients earlier in the day and experimenting with discharge lounges, where patients can wait for a ride home without tying up beds.